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Hypothyroidism: Symptoms, Causes and Treatments

Hypothyroidism:  Symptoms, causes, and treatments

Hypothyroidism and other thyroid problems
Hypothyroidism can cause fatigue, slowed metabolism, difficulties concentrating, and depression.

The Boulder Medical Center endocrinology team diagnoses and treats conditions and diseases of the endocrine system. This network of glands and hormones has widespread effects on the body, including regulating growth, metabolism, reproduction, and sexual development.

In this Boulder Medical Center Q&A session, our endocrinology team answers questions about the causes of and managing this complex and often challenging disorder.

What is hypothyroidism?

The thyroid gland is vital to our metabolism, growth, and maturation. Located at the front of the neck and shaped like a butterfly, our thyroid helps regulate many body functions by releasing hormones into the bloodstream.

If too little thyroid hormone is produced, our body can slow down. This condition is called hypothyroidism.

Hypothyroid (underactive thyroid):  What are the symptoms?

Hypothyroidism can affect males and females. Symptoms can include:

  • Loss of energy
  • Slowed metabolism
  • Mild weight gain and difficulty losing weight
  • Fatigue
  • Problems concentrating or mental slowness
  • Sensitivity to cold
  • Dry skin
  • Brittle, dry hair
  • Hair loss
  • Depression
  • Erectile dysfunction in men

When do people typically see a thyroid specialist?

Many of our patients come to our clinic for the first time because their primary doctor has diagnosed them with hypothyroidism. We also see patients already being treated for hypothyroidism, whose medication dose changes or fluctuates. Although a primary doctor is still treating these patients, they come to our clinic for a second opinion or when their physician requests help to regulate medication or address persistent symptoms.

Some patients also come to us looking for a cure. Unfortunately, there is no cure for hypothyroidism at this point, but we talk with them about treatments that can restore adequate thyroid levels and reduce their symptoms.

What causes hypothyroidism?

Hypothyroidism is usually from a condition known as Hashimoto’s Thyroiditis. Rather than protecting thyroid tissue, the body’s immune system attacks the gland, causing inflammation. As the immune system attacks the inflamed thyroid, the tissue is gradually affected and damaged by a process that causes scarring, fibrosis, and eventual loss of thyroid function.

What causes the immune system to attack the thyroid gland?

This is the million-dollar question that we don’t completely understand. We do know how the process works, though.

All of the organs in our body have little markers — let’s call them “red flags” — that tell our immune system that they belong to and are part of our body. When the immune system doesn’t see or sense these red flags, it produces antibodies that attack the gland. Over time, this impairs its ability to produce thyroid hormone, which causes hypothyroidism.

What are treatments for hypothyroidism?

As mentioned before, there is no cure for hypothyroidism. We can, however, prescribe medication that restores adequate hormone levels and reverses the symptoms. Standard treatment involves the daily use of the synthetic hormone levothyroxine (i.e., Levothroid, Synthroid, and others). Then, after a simple blood test that measures thyroid function, we determine the appropriate dose of medication.

It’s important to note that, because thyroid function will fluctuate and diminish over time, we need to monitor a patient’s medication throughout their lifetime. Dosage levels are increased or decreased depending on symptoms and the results of blood tests. Medication will compensate for the weakened thyroid, eventually taking over when the thyroid ceases to function altogether. The process of destroying the thyroid gland is slow, which is why many people with Hashimoto’s Thyroiditis can go years without symptoms.

For some, increasing their medication to compensate for reduced thyroid function happens over many years. Others go from no medicine to a total dose within six months. We reassure our patients that we will work together to find a dose of medication that will hold things steady at some point.

Additional hypothyroid treatments?

Some of our patients ask if mineral, vitamin, or herbal supplements can be helpful. As endocrinologists, we answer these questions based on our knowledge and experience with evidence-based studies and data. Unfortunately, we don’t have much literature about this treatment area, except for studies indicating that selenium may help preserve thyroid function.

We also know that healthy living benefits our immune system, leading to better thyroid function. So we talk with our patients about general recommendations such as good quality sleep, regular exercise, and a lean and green diet that avoids processed foods.

What do I need to know about taking thyroid medications?

We emphasize the importance of taking their medication consistently for our patients who are already being treated for hypothyroidism. If a patient we’re treating comes to us with elevated symptoms, we sometimes find that it doesn’t necessarily mean that their thyroid is slowing down.

We may find that their body is not absorbing the thyroid medication efficiently or that the drug’s metabolism has changed for one reason or another. We talk about a proper dosing routine that includes taking their medication at the same time every day on an empty stomach. It’s also vital that their thyroid medication is separated by at least four hours from specific vitamins and minerals, including calcium, iron, fiber, and some cholesterol medications. We also discuss other prescriptions or supplements impacting their thyroid medication.

Simply altering a few factors can often improve a patient’s symptoms. For instance, switching to Synthroid, the brand drug from the generic levothyroxine or Levothroid, has helped some patients. This is because you get the same product every time you purchase Synthroid at the pharmacy. You know that absorption and metabolism are very predictable. When you buy the generic brand, however, the pharmacy may give you one generic batch one time and a different batch the next. The active drug is the same, but the formulation – perhaps the coating on the pill – may be different and affect absorption.


About Endocrinology at Boulder Medical Center

Kimberly Lerner, MD Endocrinologist
Gillian Ditton, MD Endocrinologist

Our board-certified endocrinologists diagnose and treat various endocrine system conditions, including:

  • Cholesterol
  • Diabetes
  • Thyroid
  • Osteoporosis and other metabolic bone diseases
  • Obesity
  • Adrenal
  • Pituitary
  • Hypothalamus
  • Pancreas
  • Reproductive glands

Learn more about our Endocrinology department and providers


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